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Discussion in 'Pre-Dental' started by LLUDDS15, Mar 18, 2017.

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  1. LLUDDS15

    LLUDDS15

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    Mar 18, 2017
    North Carolina
    Dentist
    Hey Guys,

    I used to frequent these boards when I was in your position looking for advice. I may not be the best person to ask about DATs and NBDEs, but I have been in private practice for almost 2 years now, just bought my own practice about 6 months ago. It's been a hectic transition, but I LOVE having my own and being my own boss. I wanted to give back and try to help out wherever possible because I was in your position not long ago. Keep up the fight and perseverance, you will be more than happy when it's all over and done. Dentistry is absolutely the most rewarding career you could ever ask for.
     
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  3. Incis0r

    Incis0r I LOVE Dental School 2+ Year Member

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    Alterac Valley
    Thank you for doing this.

    If you had to go back to your first day of dental school, what advice would you give yourself?
     
  4. LLUDDS15

    LLUDDS15

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    Great question. For me, dental school was a completely new experience as no one in my family had ever been a dentist. I observed a few times, but just enough to learn what MO vs DO composite fillings were. My biggest advice to you is to focus less on grades (especially if you are not planning to specialize) and more on WHY and comprehension. There is so much information that gets thrown at you in dental school, you almost have to pick your battles. Instead of just memorizing to get an "A" on the exam, try to sincerely comprehend the information...ESPECIALLY in the dental classes and labs. In dental school, they will teach you the long way of doing everything, try to find a private practice dentist to mentor you and give you practical advice. Most of all, just rest assured that things will not be this impractical when you're done with school. Hopefully this helps a little.
     
    Last edited: Mar 18, 2017
  5. a.a.mar19

    a.a.mar19

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    I am trying to complete as many classes as I can before taking the DAT. I have to choose between taking a course in comparative anatomy or molecular genetics, as they are both offered at the same day and time at my school. Which should I choose? I have taken a course in mammalian physiology, so should I take molecular genetics, instead? Thanks for any help you can provide.
     
  6. stoopidmonkeycatdog

    stoopidmonkeycatdog 2+ Year Member

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    What sort of hit did you take when opening up your practice? As in did you have to stay longer in office and see your family (if you have one) less, financially, stress, etc.

    If you could go back 2 years, would you open a practice sooner, later, at the same time, or not at all?
     
  7. LLUDDS15

    LLUDDS15

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    So I actually took both of those classes, and I personally liked the molecular genetics class better. But if I were you, I would sway more toward taking the comparative anatomy class, especially if you will be doing dissections in the assigned lab. This will give you an idea of what gross anatomy will be like in your D1 year, at least at my school we worked on cadavers. Molecular genetics doesn't really have that much application to dentistry to be honest. If I were on a selections committee, I'd prefer to see the comparative anatomy. I hope this answers your question :)
     
  8. a.a.mar19

    a.a.mar19

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    Thanks you for your reply. So, you feel the comparative anatomy would be better to take before the DAT? I will take both classes before I finish my undergraduate degree.
     
    LLUDDS15 likes this.
  9. iono101

    iono101 2+ Year Member

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    If I come out of dental school with $300,000 in debt, will I be okay? If I try and live frugally and sacrifice some quality of life, I can maybe reduce the debt load to $280,000. At this point though I don't know if its worth it. Even if I live in a crappy apartment I would still have $3-$4000 to repay. When I'm paying that much a month the difference seems to be miniscule. One recent graduate I spoke to told me to just go ahead and live my life and stop worrying about the debt. On the other hand, it seems like everyone seems to preach saving every penny. I'm not sure where to draw the line.

    I'm currently applying for the NHSC Scholarship but I can't count on it.
     
  10. LLUDDS15

    LLUDDS15

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    This is a very good question, I know a lot of you are very worried about student loans with the schools being more expensive. I would tell you all to go where you can get the most clinical experience, regardless of cost. When you get out of school, you will be able to sign up for the PAYE program ("Pay As You Earn") which means they will take 10% of your AGI (if you are married, they will include your spouse's income). My wife is a teacher, so it didn't really affect us much. If you have parents helping you with school tuition costs, this obviously would make less sense for you. After 20 years, your loans are forgiven, BUT you have to pay taxes on the total amount forgiven in that tax year. So you have to save/invest for 20 years to account for that hit. In my situation, it benefited me more to push the loans as far out as possible and be disciplined enough to not spend like a fool and invest my money wisely. I owed 484k coming out, but with the amount of investments I can make vs. paying off my loan in 10 years and living like a poor person all the while...in year 20 I will be paying 280k in additional taxes for my forgiveness. I can make WAY more than that investing my money over 20 years. When I purchased my practice, I formed an S-Corporation and pay myself as an employee...around 120k per year to make my income look like less (CPA's advice). 10% of 120k per year is about 12,000 x 20 = 240,000 + the 280,000 in year 20 and I've about broke even in what I am paying back.

    I actually didn't take a hit at all when I opened my practice. I did two different associateships for a year and decided I just couldn't practice dentistry like they wanted me to (all about production and not the patient). So, I bought a practice in a very low competitive, rural area that isn't in network with any insurances and life has been absolutely fantastic. I make about 3.5x what I did in my associateship in private practice. It's VERY lucrative and, to be quite honest, rewarding getting to know your patients (always keep this #1). If you associate more than 1 year, you are wasting huge potential in my opinion. BUT I do understand, private practice ownership isn't for everyone. The hardest part is managing people to be quite honest, they will always be loyal to the old doc (if you buy existing, which I absolutely recommend) and be a little stuck in their ways. So you have to be a great communicator and yes, I stay until around 6:30pm every night wrapping everything up and paying bills, ordering supplies, reviewing treatment plans, etc. It's challenging at the end of long days, but I love coming to work in the morning knowing no one can fire me :)
     
  11. LLUDDS15

    LLUDDS15

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    Dentist
    For the DAT, I'm not sure tbh. It's been so long haha. I would think molecular genetics would be more beneficial for that, yes..
     
  12. LLUDDS15

    LLUDDS15

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    Dentist
    I have been in the panic mode you're in before. Read my post above explaining PAYE and how to use it to your advantage. The sooner you acquire a practice that has good cash flow, the better. You just have to be disciplined for 20 years. Yes, you will absolutely be fine.
     
    Last edited: Mar 18, 2017
  13. stoopidmonkeycatdog

    stoopidmonkeycatdog 2+ Year Member

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    Thank you for this reply it was perfect.

    Another question if you don't mind, what do you think of opening up a practice right away? My dad has a friend who is willing to show me the ropes after graduation, but ideally I'd go up there long enough to get comfortable and then try to open a practice as quickly as possible (do like 3-4 months). Is this plausible?
     
  14. LLUDDS15

    LLUDDS15

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    Dentist
    I would not open a practice right away to be honest. But I did have one classmate that did, and he's since opened a 2nd office. You need a little time out of dental school to learn how to get your hand speed up while keeping the same quality. In dental school, crown preps took two 4 hours appointments. In private practice, they take me 30-40 minutes for the 1st appt and 15 for the 2nd. There's a big learning curve in the real world vs. dental school. In my opinion, dental school doesn't teach enough on implants and modern dentistry (digital scanners), they teach you how to be a lab tech. There are positives to it, but who in here will be waxing up their own crowns and setting their own denture teeth? I feel like they do students a disservice in this area of dental education.

    I would absolutely take your dad's friend up on his offer though. I'd recommend shadowing him as much as possible without running him insane for a year, and then you should be ready to be on your own. You will still have a lot that you will not know until you actually own, but the idea is to make that gap of knowledge as narrow as possible.
     
  15. stoopidmonkeycatdog

    stoopidmonkeycatdog 2+ Year Member

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    Thanks! I see you're new on SDN, will you become a frequent poster? I'd like to see more of your thoughts
     
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  16. LLUDDS15

    LLUDDS15

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    Absolutely, whenever I have free time, I'd love to help you guys whenever possible. You're going to be so happy with the career you've all chosen, I'm truly excited for you.
     
  17. LLUDDS15

    LLUDDS15

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    Dentist
    Someone else asked me this question in a PM, I figured I'd share this with everyone involved in our thread here. Maybe it can help some of you.



    1) Population of area = 2,475 (one other part time dentist in town), most of my patients come from surrounding county (outside city limits). I am forty miles from the biggest city in the state, lots of people are starting to move in my direction to get out of the city. The population of the county is around 48,000.

    2) The previous owner that retired worked M-Thu from 8:00am-5:30pm and produced $1,022,000 (2016) and had a very low overhead of around 57%. He did well. We are on pace to do $1,450,000 for 2017.I obviously have a practice loan and lease that he didn't have to pay for. But I'm blessed to be still doing well. The way you pay yourself when you get out (so it's to your advantage with student loans, tax write-offs, etc.) is to setup an S-Corporation that owns your practice. Mine is named "Doctor's name, DDS, PA." You can pay yourself as much or as little as you like. To answer your question, my overhead is probably around 62% due to my practice loan, lease payment, etc. I plan to purchase the building soon through my LLC that I formed, so it'll go down with that. My lease is 3k per month, mortgage will be $1,500.I plan to take some of this extra when I get the building/land to put it towards upgrading the office, going to all electric handpieces, installing an endo system, monitors in all operatories so you can show patients the cavities they have/treatment they need and why (this is a MAJOR trust builder, and a digital scanner (3M True Definition) for my crown/bridge work.

    3) To be quite honest, this practice is busting at the seams to grow. There isn't hardly any time to do much besides basic stuff. I only do basic restorative (fillings), extractions (no 3rds--another source of growth possibly), crowns/bridges, dentures, implant (I restore them for now) crowns. I'm planning to go to an implant continuum soon called Engel Institute, supposed to be VERY good. No endo, but I plan to do anterior and premolar endo in the near future. His office wasn't setup for it, so I'm getting set in before I buy more equipment. Molar endo IMO is very difficult and less predictable, and way less profitable...so I refer those out to the endodontist. I plan to start keeping anteriors/premolars in house by this summer.

    4) I picked the practice I did because everything lined up for me, I got lucky. I learned to network with the supply reps (Patterson Dental) at my associateship position. As soon as they heard of this doctor retiring, they immediately let me know and the rest is history. Took me around 8 months do all my research, get approval from the banks, setup everything, etc. It's A LOT of work. I'd say, start looking as soon as you can, finding the right fit will take you a while. The things that were very important to me in searching for a practice were:

    A) Potential growth-this practice is obviously waiting to explode growth wise
    B) Little to no insurance involvement (not in network with lots of insurances)
    C) Little competition-which forces you to go rural---BUT as I said, I live 20 minutes from downtown Charlotte, NC (LOVE this city) and my practice is only 40 miles out of Charlotte.
    D) Location-we wanted as close to a big city as possible (airports, wife wants to go back to get her PhD and become a principal), yet in an area where I feel like I have a big impact on the community.

    5) I paid around 700k for the practice. That's about 68.5% of gross production of the previous year. They have lots of calculations they do to figure out what's fair...his CPA vs. my CPA. TBH, I didn't get involved that much with negotiations, my CPA did most of the work. We started negotiations at 680k and they started at 775k, if that means anything to you. I played hardball and acted as if I were backing out for a couple weeks, the seller contacted me saying "I'm ready to make a deal." Typically, practices in rural areas sell for around 60 to 70% of the gross production for the past year (the easiest calculation I've come up with). Since this one was so insurance/cash base friendly, it valued out to be a little on the higher end. I've seen some practices in super competitive areas sell for up to 110% of gross, which is absolutely stupid and insane to me (Charleston, SC for example). EVERYONE wants to practice there for some reason... if you move there, you'll be forced to be in network with every insurance known to mankind. My crown fee is $993 and I get every dollar of that. Those dentists in those areas get (if lucky) around $650 for crowns. After a $200 lab fee and impression materials/supplies...there's a lot less room for profit.

    I hope this helps a little.
     
  18. eldmd_32

    eldmd_32 2+ Year Member

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    This AMA has been incredibly insightful for me thus far, so thank you so much for doing it and responding so vividly and honestly!

    My question to you is, how did you become well acquainted with the business side of it all? Academics, learn along the way...?
     
  19. LLUDDS15

    LLUDDS15

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    Dentist

    To be completely honest, I'm not a business savvy person, but it's a work in progress. Being successful in the business side of private practice is all about being very organized. You spend money where and when it benefits YOU from a tax perspective. For example, the equipment in the office I purchased is very outdated. I'm waiting to update the equipment until it benefits me tax wise. Since I bought my practice in 2016, I have a lot of negative income as far as taxes goes (upside down). My CPA told me to wait until a year or so after we've used all that credit (liabilities) to make equipment upgrades because that's a business expense and lowers your bottom line as far as the gov is concerned. Basically, I'm zeroed out for the next year or two from a tax perspective.

    You learn to get creative, but to answer your question, I'd say you learn a lot along the way. For all of you, I HIGHLY recommend going to Scott Leune's "Breakaway Dental Business Masters" series in San Antonio, TX before you plan to purchase. He is the man, he built an empire of practices in TX (17 total I think) and teaches you how to systemically place your practice up for success. I'm going for a 2nd time in April with some of my old dental school classmates. While owning 17 practices in NOT AT ALL what I foresee (or want) in my future, the systems he teaches you are very simple and growth focused.

    I'll be honest, the hardest part of running a practice is staff management. Knowing when to let someone go when they are poison to the office. Knowing how to say no and realizing you have to put your business needs first, at the same time be empathetic towards staff members and their needs/wants.
     
    Last edited: Mar 19, 2017
  20. keep2camel

    keep2camel

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    Great thread!

    Does it make a difference where one goes to dental school? Contemplating Touro at the moment, and just want to get your perspective on it.
     
  21. Thank you for posting here!

    You should verify that you're a doctor, it appears to have lots of benefits.

    Doctor Verification
     
  22. LLUDDS15

    LLUDDS15

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    Dentist
    It makes a difference what your long term goals are in my opinion. If you want to specialize, it may have some degree of impact, but even then probably very little. If you just want to be a GP, go to the school that gets you the absolute most clinical experience for the cheapest amount of money. This may seem counter intuitive, but I'd email all of the admissions department and get an idea as to what their clinic requirements are. Schools where more is required most likely means you will have more access to more patients. This is a bit nit picky, but try to get a school where predoc clinic keeps most of the cases (less post doc graduate programs). If it were me picking a school, these are the criteria I'd pay attention to. I only got into one, and I'm so happy I got into the one I did...but if I had to choose between multiple, these are the factors I'd weigh.
     
    Last edited: Mar 19, 2017
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  23. LLUDDS15

    LLUDDS15

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    Dentist
    Just sent it in :)
     
  24. Alpha Centauri

    Alpha Centauri 2+ Year Member

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    Fhloston Paradise
    Amazing thread. Thank you so much for bringing some positivity around here. No doubt you are blowing up and nothing but success will be in your future, so congrats for that as a result from your hard work. My question for you is how were you able to educate yourself on the business side of dentistry? Was running the practice more based on firsthand trial and error or mentorship?
     
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  25. 8_man

    8_man Achievement Unlocked: Dental School

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    Also would like to hear about this. I feel like trying to build business acumen while in D-school would be a challenge, but if it will benefit me out the door then I'll consider educating myself.
     
  26. LLUDDS15

    LLUDDS15

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    To be quite honest, it was hours and hours of research and learning from dentists on Dentaltown.com on what/what not to do. Mistakes of others are the best way to learn. I kept a journal of all the common pitfalls and mistakes I saw people complaining about and learned from them. ALWAYS know have an humble attitude of seeking advice from seasoned vets. Never think you have "arrived" and always educate yourself through CE, books, online (Dentaltown-Howard Farran is a great one), Scott Leune is a great person to learn the business side of dentistry from. He built an empire, literally. I don't have the same goals as him, but I LOVE having an efficient/organized practice that frees me up to take time to treat my patients the way they deserve and not like an assembly line item. Make your handshake mean something, try to relate to all of your patients. I call every single one of my operative (those who got shots) patients at the end of every day to check on them. You wouldn't believe how much people love hearing from their dentist, it means you care about them and you care about the integrity of your work.
     
  27. Alpha Centauri

    Alpha Centauri 2+ Year Member

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    Dr. Leune is great. I want to try to go to his Advanced Startup over the summer, hopefully they consider me a "dental student" before I start school in the Fall!
     
    LLUDDS15 likes this.
  28. LLUDDS15

    LLUDDS15

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    I also recommend going to his Business Masters series about two months before you plan to purchase a practice.
     
    Last edited: Mar 19, 2017
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  29. LLUDDS15

    LLUDDS15

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    Take Dr. Leune's "Business Master's Series" course. I'll link it for you here:

    Business Masters Series

    Disclaimer: I have absolutely no connection to Dr. Leune or his staff and there is no financial benefit whatsoever for me sharing this info with any of you.
     
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  30. Alpha Centauri

    Alpha Centauri 2+ Year Member

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    So the advanced startup while a student wont be a "waste of time" if I am 4 years out from graduating?
     
  31. LLUDDS15

    LLUDDS15

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    I'm sort of biased and don't really think startups are wise choices (from a financial/risk standpoint-you're forced to go in network with a bunch of crappy insurances in 90+% of the cases), BUT I completely understand why people do them (want their own feel from the start). I would be very careful about studying demographics of the area you're contemplating and do lots of research before pulling the trigger. I wouldn't say it'll be a waste of time (sorry I misunderstood you at first about just now starting), but the market changes so frequently now, it may be more beneficial for you to go closer to being done with school. I don't think you'll get as much out of it is what I'm trying to say. I'd just focus on getting through D1/D2, trust me, you'll have enough on your hands with boards, mock boards, etc. When you get to your D4 year, hopefully you can be ahead on clinic reqs so that you can spend some time taking CEs. Just my opinion.
     
    Last edited: Mar 19, 2017
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  32. gangazi

    gangazi

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    How long did it take for you to get your first patient after you opened up your own practice?
    Thank you!


    Sent from my iPhone using SDN mobile
     
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  33. LLUDDS15

    LLUDDS15

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    I didn't open my own, I bought an existing practice.
     
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  34. Symphonies

    Symphonies Sleepy Idiot

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    Based on your experiences would you say that buying an existing practice is a far better gig than building one from scratch? Based on your location, I also assume corporate isn't a threat in your area? Sorry if my questions are elementary/ridiculous, I'm not too well versed in regards to life after dschool-- thanks!
     
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  35. LLUDDS15

    LLUDDS15

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    My experience is that it is absolutely more safe and financially rewarding to buy existing. About 90% of people I talk to agree. Can you be successful doing a startup? Absolutely, but it's getting harder and harder to do so due to having to go into network with so many insurances that dictate your fee schedule..and they are only getting more aggressive. No, corp is no threat in my area, fingers crossed. No, your questions are actually really good ones! Thanks for them, I hope I answered them fairly well for you. If you need me to elaborate more, just let me know :)
     
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  36. Alpha Centauri

    Alpha Centauri 2+ Year Member

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    So in other words, buy a practice is better than starting one in your eyes
     
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  37. predental21250

    predental21250 2+ Year Member

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    How much do you pay your CPA? Also how long did you work in that office before taking it over? How did most patients feel?
     
  38. nowaysurvey

    nowaysurvey 2+ Year Member

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    Thank you SO much for this AMA! Your answers have been very informative!

    A few questions...

    There has been a good about of discussions recently on SDN surrounding the aspect on whether or not dentistry is worth it considering the rising cost in its education and the amount of debt that students must tackle after graduating. Fortunately for me, I'll be tackling around $180k (altogether) if tuition/fees doesn't change much within the next four years. Many here (pre-dents) state that it's not advisable to pursue dentistry anymore once you hit the 300-350k-ish zone, which IMO think is a little absurd. I personally think dentistry as a profession still has a long (maybe) way to go before it gets to where pharmacy is right now. I've read you taken $484k, which is certainly a large amount that would scare many here on SDN on top of practice loans you recently decided to take on. You mentioned PAYE as a main reason why you aren't worried about tackling debt, but many here on SDN don't seem to feel the same way you are with that.

    My question is, 1) what do you think about the future of dentistry (not necessarily the near future, but like in a decade or two) and how would you convey that to prospective dental students when they are considering whether of not dental school is a worthy investment.

    You seem to be on a very successful path (and I hope it stays that way for you!), but 2) can you say the same for your classmates?

    3) Say one wanted to specialize (ignoring OMFS), which specialty do you think has the best future when considering more and more GPs are referring less and less now?

    Thanks!!
     
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  39. jaymaster7

    jaymaster7 2+ Year Member

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    Do you think it's better to do 1yr residency like GPR after dschool or start working immediately? What did you do and what's your opinion for new dental grads? Thank you.
     
  40. DC206R

    DC206R 2+ Year Member

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    Awesome AMA.
     
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  41. Mrdoctorcaptainsir

    Mrdoctorcaptainsir 2+ Year Member

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    The Lab
    Why did you choose dentistry over other healthcare positions, such as medicine or PA? Thx
     
  42. FlossyLady1

    FlossyLady1

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    What is the breakdown of your support staff currently? Sounds like you do a lot of extra work and having an office manager/COO would be really beneficial and save you quite a bit of time.
     
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  43. kholley25

    kholley25 2+ Year Member

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  44. How does one go about researching market saturation in different areas? It seems like a big part of succeeding as a dentist is choosing a good area to practice in. A large majority of dentists in California, Utah, and Colorado are struggling with so much competition, and many people feel obligated to remain in these areas due to family proximity. Would you agree that location is key to success? How can we know which areas are good to start practicing in?

    On a more personal note, did you ever have any reservations about being "stuck" in one place for the rest of your career? Living in a small town? Being far from family? Etc.

    (Also, you keep using the phrase "out of network with insurance companies"... what does that mean? Do your patients pay you in cash or something, with no insurance coverage? Why is it good to be out of network, and how do you know which areas have that?)
     
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  45. LLUDDS15

    LLUDDS15

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    My CPA is a dental specific (only does taxes/valuations/advice) for dentists. I pay him $475/month for monthly breakdowns of my expenses and he categorizes everything for me to take a quick glance and see how I'm performing vs. the average practices in my area. I pay him $2,700 to file my corporate (fed and state) and personal (fed and state).

    I worked one half of a day before taking over. The old doc is staying on with me for the first year to boost morale and ensure everyone of his confidence in me. We haven't had too many obstacles as of yet, but obviously there will always be a little bit of attrition, that's to be expected (patient loss). Some patients (a small #) were driving from over an hour away to see the dentist that I took over for, so I expect some of those patients to leave to find something closer and more convenient. For those who've tried me, they've all stayed (to my knowledge..so says my front desk lady).
     
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  46. kholley25

    kholley25 2+ Year Member

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    Sounds like he's FFS.
     
  47. LLUDDS15

    LLUDDS15

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    Dentist

    A few thoughts...

    1) I think the future of dentistry is polarized right now. People that HAVE to live in highly desirable areas will struggle, especially those with high student loan debt load. For those willing to do some research to find unsaturated areas and take advantage of that, and not have their lives dictated by insurance companies...the future is bright. It's really as simple as that. I think lots of "baby boomers" are finally starting to retire, which is opening up a HUGE potential in our field. They were holding on for as long as possible after the market crashed in 2008 (or so) because they lost so much..they couldn't afford to retire. Again, it depends on the sacrifices you're willing to make.

    2) Honestly, I know of only 2 other classmates of mine that have purchased practices. One is in Alaska, one is in North Carolina. We went to school in California (SoCal), with a lot of kids that HAVE to live there to be happy. They'll be forever stuck in insurance hell imo. They'll live happy lives for the most part, but will never be able to have the same (income) potential we do.I do realize, however, that income isn't that big of a deal. If being close to family makes you happiest, you should always do what makes YOU happiest.

    3) That's a very good question. As implants become more and more popular, and root canals less popular due to high rate of retreats...I'd probably say Ortho. If you can specialize in implants, that could potentially pay off. I'd stay away from Endo tbh, unless you get the implant training with it. I honestly think that in the near future, implants will be favored by insurance companies over root canals. Just my opinion though, it's all a statistical game with insurance companies, and they've just now had enough time to really get a good feel for their ROI (possible) on implants vs. RCT.
     
    Last edited: Mar 27, 2017
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  48. LLUDDS15

    LLUDDS15

    64
    213
    Mar 18, 2017
    North Carolina
    Dentist
    I'd start working unless you have to be doing higher end procedures (implants, molar endo, etc.) to be happy. To be quite honest, I do really well just doing lots of bread and butter dentistry (fillings, crowns, dentures, etc.). I'm not interested in doing molar endo, it's a waste of my time for the amount of time I put into digging for MB2s vs what I get paid to do a molar vs. a premolar/anterior (simple--take me ~30 mins total max).

    I get ~$150 more to do a 4 (possibly 5 ) canal molar and 2 to 2.5 hours of nightmarish headache than I do for a 1 or 2 canal premolar/anterior that I can finish quickly. I just refer molars to endo, it's easier for me. When they come back needing retreat, it's on them, not me.
     
    Last edited: Mar 27, 2017
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  49. LLUDDS15

    LLUDDS15

    64
    213
    Mar 18, 2017
    North Carolina
    Dentist
    I chose dentistry mainly due to a great experience/relationship I had with my dentist as a kid. I love football and hunting (which he and I chatted endlessly about), and I remember thinking how cool it was that he helped people, ran his own business, and had a few employees (but not WAY too many to comfortably manage). He was just an interesting guy. I knew I wanted to be in healthcare, and wasn't too attracted to the lifestyle that, say, an ER doc has. I wanted consistency and to drive my own ship, and to have quality time with family...but that's less than I initially thought it would be right now. That could be just because I'm new to owning my own practice, lots of paperwork and stuff to keep up with every day. Hope this helps.
     
  50. LLUDDS15

    LLUDDS15

    64
    213
    Mar 18, 2017
    North Carolina
    Dentist
    So, currently I have 3 front office workers and my wife serves as sort of an office manager. She's able to catch things I'm too busy to see during the day and bring it to my attention. I have 2 full-time hygienists, and 2 full-time assistants. I agree with you, the front desk (when systematized and ran efficiently) makes life MUCH easier on you. Front desk is a very important job, so I put a lot of thought into who I let work there. I let one of them go after 2 months of me owning the practice because we didn't mesh well.
     
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  51. LLUDDS15

    LLUDDS15

    64
    213
    Mar 18, 2017
    North Carolina
    Dentist
    Scott McDonald from Doctor Demographics (Dr Demographics | Scott McDonald & Associates specializes in market research, demographics profiling and strategic comparative analysis for small businesses.) can help you a lot with demographic research, he offers a wide variety of services. Again, networking with dental supply reps is how I found this practice...but for every 10 practices you travel to see, 9 (sometimes 10) of them are absolute duds. You need to educate yourself on what kind of practice has the most cash flow (net income). For me, this took months (almost a year) to feel comfortable negotiating. I educated myself so much that I was playing devil's advocate to my CPA and attorneys during negotiations. NEVER let anyone negotiate for you and just take whatever they say as final just because they're "professionals." Go to dentaltown.com and ask dentists questions and look up threads, research everything. It's your future and investment/life, no one cares about it as much as you. I would absolutely agree that location is not just important, it's vital to your success in the new age of dentistry.

    I have absolutely been nervous about being stuck in the wrong spot, my wife and I just prayed countless times that God would lead us to where we were supposed to be. Not trying to turn this into a religious thread, but was how I found peace with my decision. I was sort of used to being away from my family since I was in the military before dental school, so it didn't bother me too much. I still see them whenever I want, they are a 45 minute, $225 round trip flight away. :)

    So being "OON, out of network" allows me to "zero balance" bill my patients. I have my own fee schedule, and insurance companies will pay whatever the average fee is for the area, anything over that..the patient is responsible for. I keep my fees relatively low (compared to those in network with every insurance known to mankind) so the hit isn't as big for the patient. I still come out way ahead of being in network. My patient gets better quality treatment because I'm not forced to do a $600 crown where I'm forced to treat them like assembly line rats. It's definitely a FFS practice, which is the way I prefer to practice. I can't do substandard treatment and sleep well at night, but that's just me. In the end, I get paid for my time. If I get paid a little more per hour, I'm able to spend a little more time with each patient..which they deserve and pay for. Most are beyond happy to do it, I started out when I got there with about 5 new patients per month, now I have around 30 (in just 4 months) average per month. When you do good work and take your time, make jokes and make the patient laugh and relax, don't cause the patient pain due to being in a hurry, etc...they'll gladly pay a little more for your services :) Hope all of this helps you guys.
     
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